Advanced liver fibrosis is independently associated with diabetic peripheral neuropathy in type 2 diabetes

BACKGROUNDMetabolic dysfunction-associated steatotic liver disease (MASLD) frequently coexists with type 2 diabetes mellitus (T2DM), but it remains unclear whether MASLD-related liver fibrosis independently drives diabetic peripheral neuropathy (DPN) and its specific clinical subtypes. AIMTo evaluate the independent association between MASLD-related liver fibrosis and the overall risk of DPN and its specific subtypes in individuals with T2DM.advanced fibrosis (stage ≥ 3) was associated with significantly higher DPN and DSPN prevalence.Following multivariable adjustment, advanced histological fibrosis conferred an elevated risk of DPN (OR: 4.67, 95%CI: 1.33-16.38)and DSPN (OR: 13.01, 95%CI: 1.40-121.41). CONCLUSIONLiver fibrosis is independently associated with an increased risk of DPN, specifically the DSPN subtype.Clinical surveillance for neuropathy should be intensified in T2DM patients who present with advanced liver fibrosis.